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Utilization of Infertility Treatments: The Effects of Insurance Mandates

Over the last several decades, both delay of childbearing and fertility problems have become increasingly common among women in developed countries. At the same time, technological changes have made many more options available to individuals experiencing fertility problems. However, these technologies are expensive, and only 25% of health care plans in the United States cover infertility treatment. As a result of these high costs, legislation has been passed in 15 states that mandates insurance coverage of infertility treatment in private insurance plans. In this paper, we examine whether mandated insurance coverage for infertility treatment affects utilization for a specific subgroup in the population: older, highly educated women. These women are both at high risk for fertility problems, and have high rates of coverage by insurance plans affected by the mandates. We find robust evidence that while an effect of the mandates on utilization can not be found for the full population of women, the mandates do have a large and significant effect on utilization for exactly this subgroup.

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Paper provided by Department of Economics, Williams College in its series Department of Economics Working Papers with number 2008-05.

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Length: 26 pages
Date of creation: Apr 2008
Date of revision:
Publication status: forthcoming in Demography.
Handle: RePEc:wil:wileco:2008-05
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  1. Rajeev Dehejia & Adriana Lleras-Muney, 2004. "Booms, Busts, and Babies’ Health," Working Papers 250, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
  2. Zavodny, Madeline & Bitler, Marianne P., 2010. "The effect of Medicaid eligibility expansions on fertility," Social Science & Medicine, Elsevier, vol. 71(5), pages 918-924, September.
  3. Marianne P. Bitler & Christopher S. Carpenter, 2011. "Health Insurance Mandates, Mammography, and Breast Cancer Diagnoses," NBER Working Papers 16669, National Bureau of Economic Research, Inc.
  4. Marianne Bitler & Lucie Schmidt, 2006. "Health disparities and infertility: impacts of state-level insurance mandates," Department of Economics Working Papers 2006-04, Department of Economics, Williams College, revised Nov 2006.
  5. Rothschild, Michael & Stiglitz, Joseph E, 1976. "Equilibrium in Competitive Insurance Markets: An Essay on the Economics of Imperfect Information," The Quarterly Journal of Economics, MIT Press, vol. 90(4), pages 630-49, November.
  6. Amalia Miller, 2011. "The effects of motherhood timing on career path," Journal of Population Economics, Springer, vol. 24(3), pages 1071-1100, July.
  7. Marianne Bitler & Madeline Zavodny, 2000. "The effect of Medicaid eligibility expansions on births," FRB Atlanta Working Paper No. 2000-4, Federal Reserve Bank of Atlanta.
  8. Schmidt Lucie, 2005. "Effects of Infertility Insurance Mandates on Fertility," Labor and Demography 0511014, EconWPA.
  9. Gruber, Jonathan, 1994. "State-mandated benefits and employer-provided health insurance," Journal of Public Economics, Elsevier, vol. 55(3), pages 433-464, November.
  10. McKinley L. Blackburn & David E. Bloom, 1990. "Fertility Timing, Wages, and Human Capital," NBER Working Papers 3422, National Bureau of Economic Research, Inc.
  11. Marianne P. Bitler, 2005. "Effects of Increased Access to Infertility Treatment on Infant and Child Health Outcomes: Evidence from Health Insurance Mandate," Working Papers 330, RAND Corporation Publications Department.
  12. Robert Kaestner & Kosali Ilayperuma Simon, 2002. "Labor Market Consequences of State Health Insurance Regulation," ILR Review, Cornell University, ILR School, vol. 56(1), pages 136-159, October.
  13. Timothy Conley & Christopher Taber, 2005. "Inference with "Difference in Differences" with a Small Number of Policy Changes," NBER Technical Working Papers 0312, National Bureau of Economic Research, Inc.
  14. Jane Menken, 1985. "Age and fertility: How late can you wait?," Demography, Springer, vol. 22(4), pages 469-483, November.
  15. Paul Oyer, 2005. "Salary or Benefits?," NBER Working Papers 11817, National Bureau of Economic Research, Inc.
  16. M. Kate Bundorf & Melinda Henne & Laurence Baker, 2007. "Mandated Health Insurance Benefits and the Utilization and Outcomes of Infertility Treatments," NBER Working Papers 12820, National Bureau of Economic Research, Inc.
  17. Bundorf, M. Kate & Chun, Natalie & Goda, Gopi Shah & Kessler, Daniel P., 2009. "Do markets respond to quality information? The case of fertility clinics," Journal of Health Economics, Elsevier, vol. 28(3), pages 718-727, May.
  18. Liu, Zhimei & Dow, William H. & Norton, Edward C., 2004. "Effect of drive-through delivery laws on postpartum length of stay and hospital charges," Journal of Health Economics, Elsevier, vol. 23(1), pages 129-155, January.
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